Six months into the pandemic called COVID-19, people are fighting and dying over face masks. There have been stabbings and shootings because someone was or was not wearing a mask. Read about “The Fight Over Face Masks” here. Even after six months, many individuals remain confused about face masks.
The Spread of the Coronavirus:
We have received a substantial number of comments from people who disagree with the president’s top public health officer at the CDC. Dr. Robert Redfield wrote with colleagues that:
“broad adoption of cloth face coverings is a civic duty…”
That has not convinced these readers:
D.B. believes that a healthy lifestyle is more important than a face mask:
“Masks are simply delaying when any of us will get the virus. We have to get back to our lives and just try to be as healthy as possible. There is still a 98%+ recovery rate for the virus. Lastly, if masks worked, why did people in China get the virus? I’m not saying don’t wear one, but it is just one of many tools, with a healthy lifestyle being the most important.”
We do not disagree that a healthy lifestyle is important. But we don’t see it as an either/or decision. We think a healthy lifestyle is always important. Face masks can also reduce the spread of the coronavirus.
Ron disagrees and says that masks are useless:
“Since coronavirus can pass through ANY mask including the N-95, what is the reason for making masks mandatory? They probably are 99.9 % useless.”
Ron asserts that all masks, including N95 respirators, are useless without citing any scientific evidence to back up his claim. Here at The People’s Pharmacy, we do like science. That is why our articles have so many scientific citations and links to the original research.
Tom says he is not confused about face masks:
“I have worn a mask in total about a half hour since this nonsense started in March. I have been among many people and even in crowds nearing 100, without masking. I have not been sick in any way.
“There is no scientific proof face masks work. They restrict breathing. The death counts are false; the risk of death is overstated; the experts offer totally conflicting advice. This is nothing more than a political statement designed to control our lives. I refuse to obey, and will resist this idiocy till the day I pass on.”
These are just a fraction of the messages that we have received on this website. We have tried hard to stick to the science. The most recent study from Duke University measured the number of detectable particles that pass through a mask when a subject repeatedly says “STAY HEALTHY, PEOPLE.” Here is a link to what they found:
Which Face Masks Work Best? Beware Some N95s!
There are now so many face masks on the market it is hard to know which to buy. A new Duke study investigated which face masks work best.
Should People Be Confused About Face Masks?
No doubt you have heard the expression:
“Don’t let the perfect be the enemy of the good.”
This concept could be applied to the contentious issue of face masks.
CDC director, Dr. Robert Redfield, and his colleagues acknowledged in their JAMA editorial (JAMA, July 14, 2020) that we don’t have scientifically rigorous randomized controlled trials (RCTs) proving the efficacy of cloth face masks against COVID-19. Implementing an experiment that actually tests live coronavirus transmission in healthy people would be completely unethical and immoral.
The CDC Did Flip-Flop:
At one point the CDC was not very enthusiastic about face masks. That reinforced skepticism. When the CDC changed its tune, lots of people were confused about face masks.
Now, however, there is evidence that face masks can be helpful in this pandemic.
Dr. Redfield told the Wall Street Journal (July 27, 2020) that:
“…he believes the pandemic could be brought under control over the next four to eight weeks if ‘we could get everybody to wear a mask right now.’”
In the vein of perfect vs. good, Dr. Redfield and his colleagues recognize that:
“Some have raised concerns that homemade face coverings made from household fabrics may be inferior compared with commercially manufactured products.”
However, even homemade cloth facial coverings can be helpful.
The Duke Study of Face Masks:
Readers have asked for photos of the various masks that were tested in the recent Duke Study. Here is a link to the article. If you click on Figure 2 you will see the 14 masks that were tested. You can download the “high-res” image to get a better sense of what the masks actually look like.
This is what the Duke University study revealed:
“In effect, the mask acts as a temporal low pass filter, smoothens the droplet rate over time, and reduces the overall transmission. For the bandana (red curve), the droplet rate is merely reduced by a factor of two and the repetitions of the speech are still noticeable. The effect of the cotton mask (orange curve) is much stronger. The speech pattern is no longer recognizable and most of the droplets, compared to the control trial, are suppressed.”
Although cloth face masks don’t prevent every tiny particle from getting through, they do reduce the viral load. There is no doubt that N95 masks without exhalation valves are the best. Surgical masks and double or triple-layer cloth masks are also pretty darn good.
Should People Remain Confused About Face Masks?
A study published in JAMA (July 14, 2020) reported that when health care workers and patients all wore face masks, the rate of transmission of COVID-19 in a large hospital system dropped dramatically.
In another instance, two hair stylists at a salon in Springfield, MO, were diagnosed with COVID-19. Just prior to their diagnosis, they cut 139 clients’ hair. However, the stylists and their clients were wearing masks throughout the interactions. None of the clients subsequently came down with the coronavirus.
The Kansas “Experiment:”
The most recent example of the value of wearing face masks in public comes from an inadvertent natural experiment in Kansas. Early in July the governor issued an order that face masks would be mandatory in public buildings. Officials in 90 counties of the state resisted this order. However, in 15 counties officials complied and people wore masks.
Although it is not a RCT, this experiment was revealing. The counties that refused mandatory masks acted as a control. Their COVID-19 infection rates were substantially higher than those in the counties that followed the masking order.
According to Dr. Lee Norman, secretary of the Kansas Department of Health and Environment (The Kansas City Star, Aug. 7, 2020):
“In the counties with no mask mandate, there is no decrease in the number of cases per capita…The bottom line is, do masks work? Here, in this natural experiment called Kansas…some counties have been the control group with no masks and some have been the experimental group with masks being worn. The experimental group is winning the battle. All of the improvement in the case development comes from those counties wearing masks.”
The UNC Experiment:
The University of North Carolina (UNC) started the school year a bit earlier than many other universities and colleges. Students were hoping to be able to attend classes in person on the beautiful campus.
On August 17th, however, the administration reported that there were clusters of COVID-19 infections within three days (News&Observer, Aug. 17, 2020):
“The announcement follows four COVID-19 clusters reported in three days in dorms, apartments and a fraternity house. UNC has reported 324 confirmed cases — 279 students and 45 staff members — since February, according to its online dashboard.”
The latest news:
“UNC-Chapel Hill will move all undergraduate classes online starting Wednesday after 130 more students tested positive for the coronavirus last week, the university announced Monday.”
This is a drastic step. But let’s be honest. It is hard for some young people to wear masks at frat parties, in communal bathrooms, cafeterias, dorm lounges or apartments. Changing behavior is challenging and peer pressure to hang out without a mask is powerful.
Are You Still Confused About Face Masks?
Masks are not perfect, not even N95 respirators. Nevertheless, they are significantly better than no protection. We have yet to hear alternatives from people who hate the idea of masks. If you are one of those people, please share your science-based strategies for reducing transmission of COVID-19 in the comment section below.
At last count, John Hopkins reports well over 5 million cases of the coronavirus in the US. More than 170,000 people have died.
Until we have effective treatments or protective vaccines, we agree with Dr. Redfield at the CDC that masks are an important tool in preventing illness and death from COVID-19.
We welcome your respectful and science-based comments below. Feel free to share this article with friends, co-workers and family members by scrolling to the top of the page and clicking on one of the icons for email, Facebook or Twitter.
